Friday, June 10, 2022

Bryce Wilkinson: Health “Reform” – this week’s step towards a more racially-divisive future

A race-neutral approach to government health (and welfare) spending would give the same treatment to people in the same circumstances. It would ignore irrelevant matters such as race, ethnicity, religion, gender, or creed. Horizontal equity requires no less.

The government seeks instead to discriminate between people by assigning them to groups and treating some groups as a ‘priority’ population.

Its undemocratic juggernaut to divide New Zealanders on ethnic grounds took another step this week with the 3rd reading of the Pae Ora (Healthy Futures) Bill. That the Governor-General will assent is a given.

The Bill divides New Zealanders into two groups – those whose access to health services will presumably be determined by the new Māori Health Authority, and everyone else.

Astonishingly, section 59 of the Bill prevents the Minister from giving any non-partisan direction to the Māori Health Authority. The Minister may only give a direction that “relates to improving equity of access and outcomes for Māori”. And who will be the judge of that?

Government health bodies are to be Treaty savvy. They must understand Mātauranga Māori and “Māori perspectives of services”. Who will determine that? The Minister’s new Hauroa Māori Health Advisory Committee has pole position.

The Bill requires the system to strive “to eliminate health disparities, particularly for Māori”. This focus over-rides individual needs. It ignores individual variability within and across groups. It risks violating horizontal equity by favouring well-off Māori relative to worse off non-Māori.

Who is to distinguish Māori from non-Māori, and on what basis? The Bill is silent on this.

Moreover, no amount of spending on health care can eliminate health outcome disparities. Other factors such as lifestyle choices and socio-economic disparities are too important.

The inevitable ongoing failure to achieve elimination invites the new Māori Health Authority to call annually for ever-more funding per capita. Others will call ‘inadequate’ funding ‘racist’.

Such unsavoury assertions distract from the real issue – achieving better outcomes for those who are most struggling to provide for themselves, regardless of group politics.

Overall, the Bill presumes Wellington knows best. The Minister must impose a Charter, strategies, plans and directions for the entire public-funded health system. Every region will have a Wellington-imposed plan.

This is elitist. Wellington does not know best. People need choices, not plans.

Dr Bryce Wilkinson is a Senior Fellow at The New Zealand Initiative, Director of Capital Economics, and former Director of the New Zealand Treasury. His articles can be seen HERE.


Doug Longmire said...

The elephant in the room here, is the same elephant that has been sidestepped and put in the too hard basket.
In all this racist legislation, there is no legal definition of "Maori".
That's it !! Full stop.

Allan Maclean said...

This is apartheid, pure and simple.

Empathic said...

A major concern is that huge resources (i.e. money from our pockets) will be wasted on ineffective or underperforming initiatives based on a false assertion that anti-Maori racism in the health services is responsible for poorer Maori health outcomes. Traditional Maori healing methods and knowledge not validated by scientific means will be funded but unlikely to achieve better outcomes beyond placebo effects. Health disciplines will be obliged to abandon an established need to justify their interventions based on evidence. Some, perhaps much of the Maori Health practices will be based on superstition and taking them seriously will promote useless and even dangerous superstitious beliefs more widely.

There is justification for making health services more welcoming and meaningful to Maori, possibly even having Maori-specific services within current infrastructure. That in fact already occurs in various health services including mental health although that could usefully be legally ring-fenced because such special support for Maori has in the past been the first to be disposed of when general budgets blow out. However, the current restructuring of health will be hugely expensive and racially divisive while there is no good basis for expecting it will achieve much or any improvement in outcomes.

Helen Weston said...

On June 14 the Governor General gave the 'green light' to the Pae Ora Bill with the Royal Assent. No guesses which side of the bed she is on!!

Unknown said...

This Bill takes no account of the proportion of different races in each person. Does a person with 1/16th Maori blood not have 15/16th of some other race. Surely the Maori part is not so dominant it cancels out all other factors.
The whole idea is ridiculous and pure apartheid.
Whatever happened to prioritising healthcare on clinical need.

Robert Arthur said...

I wonder if any of the few non maori in the Labour caucus ever express reservations about the trend in NZ. Or, as with most of the general population, are they all in total fear of cancellation? Little wonder the likes of reasonable pleasant folk like Faaafoi toss it in.